Individual
MAHMOUD F HASSUNEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 N MADISON AVE, ANDERSON, IN 46011-3453
(765) 298-4242
(317) 355-8734
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01045596
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000603504
ANTHEM - TIPTON HOSPITAL
IN
05
—
200187390
—
IN
01
—
P01291567
RAILROAD MEDICARE
IN
Enumeration date
12/15/2005
Last updated
07/26/2022
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